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U.S. Department of Health and Human Services

MAUDE Adverse Event Report: BIOSENSE WEBSTER INC NGEN RF GENERATOR, US; CARDIAC ABLATION PERCUTANEOUS CATHETER

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BIOSENSE WEBSTER INC NGEN RF GENERATOR, US; CARDIAC ABLATION PERCUTANEOUS CATHETER Back to Search Results
Catalog Number D138402
Device Problems Overheating of Device (1437); Communication or Transmission Problem (2896)
Patient Problem No Clinical Signs, Symptoms or Conditions (4582)
Event Date 01/18/2024
Event Type  malfunction  
Manufacturer Narrative
The hardware investigation has begun but it has not been completed at this time.When the investigational analysis has been completed, a supplemental 3500a report will be submitted.This report is being submitted pursuant to the provisions of 21 cfr, part 803.This report may be based on information which has not been investigated or verified prior to the required reporting date.This report does not reflect a conclusion by biosense webster, inc., or its employees that the report constitutes an admission that the product, biosense webster, inc., or its employees caused or contributed to the potential event described in this report.If information is obtained that was not available for the initial report, a follow-up report will be filed as appropriate.If additional information is received regarding this event, a supplemental 3500a report will be submitted to the fda.Manufacturer's reference number: (b)(4).
 
Event Description
It was reported that a patient underwent an atrial fibrillation (afib) ablation procedure with a ngen rf generator and it was noted that the base of the monitor was extremely hot.It was reported that the radiofrequency (rf) data could not be sent properly.They inspected the second ¿monitor on the boom¿ and the base of the monitor was extremely hot.They unplugged the power source to cool down the monitor, however, the issue persisted.They rebooted the monitor and the issue persisted.They reconnected the monitor and the issue was resolved.No adverse patient consequence was reported.They recently upgraded the monitors to v2.0b on 29-dec-2023 so the ngen could communicate with clarence's recording system.They also noticed that the a/c power adapter has been demonstrating incomplete contact recently and making an arcing sound when plugging in and unplugging.
 
Manufacturer Narrative
It was reported that a patient underwent an atrial fibrillation (afib) ablation procedure with a ngen rf generator, and it was noted that the base of the monitor was extremely hot.It was reported that the radiofrequency (rf) data could not be sent properly.They inspected the second ¿monitor on the boom¿ and the base of the monitor was extremely hot.They unplugged the power source to cool down the monitor, however, the issue persisted.They rebooted the monitor and the issue persisted.They reconnected the monitor and the issue was resolved.No adverse patient consequence was reported.They recently upgraded the monitors to v2.0b on 29-dec-2023 so the ngen could communicate with clarence's recording system.They also noticed that the a/c power adapter has been demonstrating incomplete contact recently and making an arcing sound when plugging in and unplugging.Hardware investigation details: it was confirmed that the monitor was defective, so it was replaced.However, no evidence of further analysis of the defective parts was retrieved at this time.A device history record evaluation was performed for the finished device number, and no internal actions related to the reported condition were identified.Additionally, the manufactured date has been provided.Therefore, field h4.Device manufacture date has been populated.All devices are manufactured, inspected, and released to approved specifications as part of biosense webster's quality process.If additional information is received regarding this event, a supplemental 3500a report will be submitted to the fda.Manufacturer's reference number: (b)(4).
 
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Brand Name
NGEN RF GENERATOR, US
Type of Device
CARDIAC ABLATION PERCUTANEOUS CATHETER
Manufacturer (Section D)
BIOSENSE WEBSTER INC
31 technology drive, suite 200
irvine CA 92618
Manufacturer (Section G)
FLEX
hamatechet 2
migdal haemek
IS  
Manufacturer Contact
kate karberg
31 technology dr
irvine, CA 92618
3035526892
MDR Report Key18686968
MDR Text Key335215210
Report Number2029046-2024-00463
Device Sequence Number1
Product Code LPB
Combination Product (y/n)N
Reporter Country CodeUS
PMA/PMN Number
P030031
Number of Events Reported1
Summary Report (Y/N)N
Report Source Manufacturer
Source Type Health Professional,Company Representative
Reporter Occupation Other
Type of Report Initial,Followup
Report Date 04/08/2024
1 Device was Involved in the Event
1 Patient was Involved in the Event
Date FDA Received02/12/2024
Is this an Adverse Event Report? No
Is this a Product Problem Report? Yes
Device Operator Health Professional
Device Catalogue NumberD138402
Was Device Available for Evaluation? No
Is the Reporter a Health Professional? No
Date Manufacturer Received03/12/2024
Was Device Evaluated by Manufacturer? Yes
Date Device Manufactured07/13/2023
Is the Device Single Use? No
Is This a Reprocessed and Reused Single-Use Device? No
Type of Device Usage Reuse
Patient Sequence Number1
Treatment
NGEN PUMP, US CONFIGURATION; UNK_SMART TOUCH BIDIRECTIONAL SF
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